Overview

Membranous nephropathy is a type of kidney disease that affects the glomeruli, the small blood vessels in the kidneys that filter waste and excess fluids from the blood. In membranous nephropathy, one of the glomeruli membranes becomes damaged, and this can lead to proteinuria (the presence of excess protein in the urine) and other symptoms such as oedema (swelling) and hypertension (high blood pressure).

Membranous nephropathy (MN) is generally considered an autoimmune kidney disease resulting from an abnormal immune system response that leads to damage to the glomeruli in the kidneys.

What causes Membranous Nephropathy?

Primary: The immune response in the body is triggered to fight foreign pathogens. In the case of MN, the immune response attacks the membranes of the kidney’s filtering units. A good indication of MN is when there is a high amount of protein in the blood that is caused by damage to the podocyte(one of the three components of the membrane) This is called primary MN.

Secondary: Membranous nephropathy (MN) can also occur as a secondary condition, meaning that it is associated with an underlying disease or condition. Some of the secondary causes of MN include:

- Infections: MN can be associated with certain infections, such as hepatitis B or C, syphilis, and malaria.
- Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), gold salts, and penicillamine, can cause MN.
- Systemic diseases: MN can be associated with certain systemic diseases, such as lupus erythematosus, Sjogren's syndrome, and sarcoidosis.
- Cancer: MN can be associated with certain types of cancer, particularly solid tumours such as lung and colon cancer.
- Genetic mutations: In rare cases, genetic mutations can cause MN to run in families.

Symptoms of Membranous Nephropathy:

The Glomerular disease symptoms of membranous nephropathy can vary and may develop slowly. Some people show no symptoms of the same, while others may experience several symptoms of membranous nephropathy, including:

- Swelling (Edema): Swelling in the legs, feet, ankles, and sometimes the face and hands due to excess fluid in the tissues.
- Proteinuria: Proteinuria is excess protein in the urine, which can result in foamy urine.
- Fatigue: Feeling tired or fatigued may occur due to the loss of protein and nutrients through the urine.
- Weight gain: Unexplained weight gain can occur due to fluid retention in the body.
- High blood pressure: Membranous nephropathy can cause high blood pressure, leading to additional complications if left untreated.
- Decreased urine output: Decreased urine output may occur due to kidney damage.
- Elevated cholesterol levels: Elevated cholesterol levels can occur due to protein loss through the urine.
- Nephrotic syndrome: A condition characterised by proteinuria, low levels of protein in the blood, high levels of cholesterol and triglycerides, and swelling.

Some people with membranous nephropathy may not experience any symptoms initially, and the condition may be discovered during routine blood or urine tests. However, if one has any of these symptoms or concerns about kidney function? In that case, it's important to consult with a doctor for a proper membranous nephropathy diagnosis and treatment.

Treatment options for membranous nephropathy:

The treatment options for membranous nephropathy depend on the individual's overall health. The treatment controls symptoms, prevents complications and slows the progression of kidney damage. Some treatment options for membranous nephropathy include:

- Medications: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are often prescribed to control blood pressure and reduce proteinuria.
- Diet and lifestyle changes: Adopting a low-sodium diet and limiting protein intake can help reduce the workload on the kidneys and improve kidney function. It also can help manage blood pressure and reduce the risk of complications.
- Dialysis or kidney transplant: In severe cases of membranous nephropathy, dialysis or kidney transplant may be necessary to replace the function of the damaged kidneys.
- Monitoring and follow-up care: Regular check-ups with a healthcare provider to monitor kidney function, blood pressure, and proteinuria levels are important to track the progression of the disease and make necessary adjustments to treatment.

When any factors mentioned earlier are followed, or the situation is still the same, proteinuria does not decline during the observation. In that case, your nephrologist will likely use immunosuppressive therapy.

- Immunosuppressive therapy: Immunosuppressive treatment refers to using drugs or other methods to suppress or weaken the immune system. Not all people will undergo this therapy during the treatment process of MN, but it is still an important part of the treatment for many people with this disease.

When to Consult a Doctor

You can also get in touch with the expert nephrology doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Summing Up:

"Twenty million more people suffer from chronic renal disease, a condition marked by a steady deterioration in kidney function that can eventually result in kidney failure."

Membranous nephropathy is a kidney disease that can lead to kidney failure. Today's generation's lifestyle and the environment play an important role in causing these diseases. Therefore, the right treatment at the right time is necessary to prevent patients from fatal causes. With the right treatment, following a healthy diet chart that should include low-sodium and nutritious food is essential. This will help the patient in fast recovery from membranous nephropathy.

Frequently Asked Questions

Q: What are the causes of membranous nephropathy? A: The causes of membranous nephropathy are -

- Cancer
- Hepatitis B
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Systemic lupus erythematosus
- Other infections and diseases

Q: What causes membranous nephropathy? A: It can occur due to other underlying conditions such as infections, medications, autoimmune diseases, malignancies, or other unknown causes (idiopathic MN).

Q: What is the treatment of choice for membranous nephropathy? A: The treatment choice for membranous nephropathy depends on the underlying cause and the severity of the disease, but immunosuppressive therapy is often the first-line treatment for idiopathic MN.

Q: What are the symptoms of membranous nephropathy? A: The signs and symptoms of membranous nephropathy can vary but commonly include swelling (oedema) in the legs, feet, and ankles, proteinuria (protein in the urine), fatigue, weakness, and elevated blood pressure. Other symptoms may include foamy urine, weight gain, loss of appetite, and in advanced cases, shortness of breath and fluid accumulation in the lungs.

Q: What is stage 1 membranous nephropathy? A: Stage 1 membranous nephropathy is the early stage of the disease, characterised by low levels of proteinuria (less than 4g/day) and normal kidney function. There may be no noticeable symptoms, and the condition is often detected incidentally during routine urine or blood tests. Regular monitoring and treatment may be necessary to prevent the progression of MN to more advanced stages.

References

- https://my.clevelandclinic.org/health/diseases/21154-membranous-nephropathy
- https://www.kidney.org/atoz/content/membranous-nephropathy-mn